Full text not available from this repository.

Abstract

Objectives: To assess the efficacy of a pro-active, absolute cardiovascular risk-guided approach to opportunistically modifying cardiovascular risk factors in patients without coronary ischaemia attending a chest pain clinic.Design: Prospective, randomised, open label, blinded endpoint study.Setting: The rapid access chest pain clinic of Royal Hobart Hospital, a tertiary hospital.Participants: Patients who presented to the chest pain clinic between 1 July 2014 and 31 December 2017 who had intermediate to high absolute cardiovascular risk scores (5-year risk ≥ 8%). Patients with known cardiac disease or from groups with clinically determined high risk of cardiovascular disease were excluded.Main outcome measures: The primary endpoint was change in 5-year absolute risk score (Australian absolute risk calculator) at follow-up (at least 12 months after baseline assessment). Secondary endpoints were changes in lipid profile, blood pressure, smoking status, and body mass index, and major adverse cardiovascular events.Results: The mean change in risk at follow-up was +0.4 percentage points (95% CI, -0.8 to 1.5 percentage points) for the 98 control group patients and -2.4 percentage points (95% CI, -1.5 to -3.4 percentage points) for the 91 intervention group patients; the between-group difference in change was 2.7 percentage points (95% CI, 1.2-4.1 percentage points). Mean changes in lipid profile, systolic blood pressure, and smoking status were larger for the intervention group, but not statistically different from those for the control group.Conclusions: An absolute cardiovascular risk-guided, pro-active risk factor management strategy employed opportunistically in a chest pain clinic significantly improved 5-year absolute cardiovascular risk scores.

Item Type:	Article
Authors/Creators:	Black, JA and Campbell, JA and Parker, SC and Sharman, JE and Nelson, MR and Otahal, P and Hamilton, G and Marwick, TH
Keywords:	cardiology, rapid access chest pain clinic, quality of life
Journal or Publication Title:	Medical Journal of Australia
Publisher:	Australasian Med Publ Co Ltd
ISSN:	0025-729X
DOI / ID Number:	10.5694/mja2.50960
Copyright Information:	Copyright 2021 AMPCo Pty Ltd
Related URLs:	Google Scholar: Sharman, JE UTAS Profile: Sharman, JE Google Scholar: Nelson, MR UTAS Profile: Nelson, MR Google Scholar: Otahal, P UTAS Profile: Otahal, P UTAS Profile: Marwick, TH
Item Statistics:	View statistics for this item

Actions (login required)

Item Control Page